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Mukai S, Itoi T, Sofuni A, Tsuchiya T, Tanaka R, Tonozuka R, Kojima H. Bridging endoscopic pancreatic stenting for disconnected pancreatic duct syndrome using a rendezvous technique from a walled-off necrosis cavity. Endoscopy 2024; 56:E29-E30. [PMID: 38194989 PMCID: PMC10776267 DOI: 10.1055/a-2219-2672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- Shuntaro Mukai
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Takao Itoi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Atsushi Sofuni
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Takasyoshi Tsuchiya
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Reina Tanaka
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Ryosuke Tonozuka
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Hiroyuki Kojima
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
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2
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Guinot PG, Gallner D, De Baros JD, Nguyen M, Bouhemad B. Exploring the association between gastrointestinal dysfunction and abdominal venous congestion in ICU. Intensive Crit Care Nurs 2024; 82:103639. [PMID: 38341985 DOI: 10.1016/j.iccn.2024.103639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/22/2024] [Accepted: 01/28/2024] [Indexed: 02/13/2024]
Affiliation(s)
- Pierre-Grégoire Guinot
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, 21000 Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France.
| | - Doriane Gallner
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, 21000 Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France
| | - Jose Dantas De Baros
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, 21000 Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France
| | - Maxime Nguyen
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, 21000 Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France
| | - Belaid Bouhemad
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, 21000 Dijon, France; University of Burgundy and Franche-Comté, LNC UMR1231, F-21000 Dijon, France
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3
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Al-Turaihi Z, Simon M, Smith RJ, Horrow MM. US of the Portal Vein. Radiographics 2024; 44:e230118. [PMID: 38573815 DOI: 10.1148/rg.230118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Affiliation(s)
- Zahraa Al-Turaihi
- From the Department of Radiology, Jefferson Einstein Hospital, 5501 Old York Rd, Philadelphia, PA 19141
| | - Matthew Simon
- From the Department of Radiology, Jefferson Einstein Hospital, 5501 Old York Rd, Philadelphia, PA 19141
| | - Ryan J Smith
- From the Department of Radiology, Jefferson Einstein Hospital, 5501 Old York Rd, Philadelphia, PA 19141
| | - Mindy M Horrow
- From the Department of Radiology, Jefferson Einstein Hospital, 5501 Old York Rd, Philadelphia, PA 19141
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4
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Kavanaugh M, Shah HJ. Widespread Reactive Lymphatic and Splenic FDG Avidity After mRNA COVID Vaccination. Clin Nucl Med 2024; 49:457-458. [PMID: 38465978 DOI: 10.1097/rlu.0000000000005150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
ABSTRACT A 75-year-old woman with history of metastatic lung adenocarcinoma in remission develops new widespread FDG-avid lymphadenopathy in the neck, chest, abdomen, and pelvis on surveillance PET/CT, as well as intense FDG uptake in the spleen, without evidence of local recurrence. Short-term follow-up PET demonstrates near-complete resolution of FDG-avid lymphatic and splenic FDG avidity without interval change in management. Further history reveals that the patient received her fifth dose of COVID mRNA vaccine 6 days before the abnormal PET. Although unilateral axillary adenopathy after COVID vaccination is well-recognized, this widespread symmetric lymphatic and splenic FDG avidity is a significantly rarer phenomenon.
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5
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Shanthanna H, Joshi GP. Noninferiority trials in acute pain research: a valid approach or a slippery slope? Br J Anaesth 2024; 132:1027-1032. [PMID: 38642963 DOI: 10.1016/j.bja.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 04/22/2024] Open
Abstract
The conduct and reporting of studies with a noninferiority hypothesis is challenging because of the complexity involved in their design and interpretation. However, studies with a noninferiority design have increased in popularity. A recently published trial reported on the noninferiority of lidocaine infusion to epidural analgesia in major abdominal surgeries. Apart from needing a critical appraisal, this draws attention to improve our understanding of noninferiority study framework and its unique features. Given the increasing focus on using various analgesic adjuncts and multiple approaches to fascial plane blocks to avoid more definitive and standard approaches, it is imperative that particular attention is paid to appropriate execution and reporting of noninferiority studies.
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Affiliation(s)
- Harsha Shanthanna
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada.
| | - Girish P Joshi
- Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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6
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Do QH, Hoang VT, Chansomphou V, Hoang DT. Endoscopic management of migrated intrauterine device in the stomach. Int J Gynaecol Obstet 2024; 165:830-831. [PMID: 38140800 DOI: 10.1002/ijgo.15327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
SynopsisEctopic intrauterine devices to the gastric wall are extremely rare and they can be managed by upper gastrointestinal endoscopy.
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Affiliation(s)
- Quang Hai Do
- Division of Endoscopy, Department of Radiology, Hai Phong - Vinh Bao International Hospital, Hai Phong, Vietnam
| | - Van Trung Hoang
- Department of Radiology, Thien Hanh Hospital, Buon Ma Thuot, Vietnam
| | - Vichit Chansomphou
- Department of Radiology, Savannakhet Medical-Diagnostic Center, Kaysone Phomvihane, Laos
| | - Duc Thanh Hoang
- Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, USA
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7
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Mohin M, Mukherjee R, Dewan L, Karan S, Chatterjee U. Cytological findings in a case of undifferentiated embryonal sarcoma of liver in a child: Report of a case with review of literature. Cytopathology 2024; 35:416-420. [PMID: 38226775 DOI: 10.1111/cyt.13357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/15/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024]
Abstract
The cytological features of undifferentiated embryonal sarcoma of the liver in a child are described in this report. It is important to be aware of this entity and its cytological features in order to avoid misdiagnosis with more common entities such as the hepatoblastoma.
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Affiliation(s)
- Md Mohin
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Raktim Mukherjee
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Lucky Dewan
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Sanjana Karan
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
| | - Uttara Chatterjee
- Department of Pathology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
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8
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van Bodegraven EA, Balduzzi A, van Ramshorst TME, Malleo G, Vissers FL, van Hilst J, Festen S, Abu Hilal M, Asbun HJ, Michiels N, Koerkamp BG, Busch ORC, Daams F, Luyer MDP, Ramera M, Marchegiani G, Klaase JM, Molenaar IQ, de Pastena M, Lionetto G, Vacca PG, van Santvoort HC, Stommel MWJ, Lips DJ, Coolsen MME, Mieog JSD, Salvia R, van Eijck CHJ, Besselink MG. Prophylactic abdominal drainage after distal pancreatectomy (PANDORINA): an international, multicentre, open-label, randomised controlled, non-inferiority trial. Lancet Gastroenterol Hepatol 2024; 9:438-447. [PMID: 38499019 DOI: 10.1016/s2468-1253(24)00037-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Prophylactic passive abdominal drainage is standard practice after distal pancreatectomy. This approach aims to mitigate the consequences of postoperative pancreatic fistula (POPF) but its added value, especially in patients at low risk of POPF, is currently being debated. We aimed to assess the non-inferiority of a no-drain policy in patients after distal pancreatectomy. METHODS In this international, multicentre, open-label, randomised controlled, non-inferiority trial, we recruited patients aged 18 years or older undergoing open or minimally invasive elective distal pancreatectomy for all indications in 12 centres in the Netherlands and Italy. We excluded patients with an American Society of Anesthesiology (ASA) physical status of 4-5 or WHO performance status of 3-4, added by amendment following the death of a patient with ASA 4 due to a pre-existing cardiac condition. Patients were randomly assigned (1:1) intraoperatively by permuted blocks (size four to eight) to either no drain or prophylactic passive drain placement, stratified by annual centre volume (<40 or ≥40 distal pancreatectomies) and low risk or high risk of grade B or C POPF. High-risk was defined as a pancreatic duct of more than 3 mm in diameter, a pancreatic thickness at the neck of more than 19 mm, or both, based on the Distal Pancreatectomy Fistula Risk Score. Other patients were considered low-risk. The primary outcome was the rate of major morbidity (Clavien-Dindo score ≥III), and the most relevant secondary outcome was grade B or C POPF, grading per the International Study Group for Pancreatic Surgery. Outcomes were assessed up to 90 days postoperatively and analysed in the intention-to-treat population and per-protocol population, which only included patients who received the allocated treatment. A prespecified non-inferiority margin of 8% was compared with the upper limit of the two-sided 95% CI (Wald) of unadjusted risk difference to assess non-inferiority. This trial is closed and registered in the Netherlands Trial Registry, NL9116. FINDINGS Between Oct 3, 2020, and April 28, 2023, 376 patients were screened for eligibility and 282 patients were randomly assigned to the no-drain group (n=138; 75 [54%] women and 63 [46%] men) or the drain group (n=144; 73 [51%] women and 71 [49%] men). Seven patients in the no-drain group received a drain intraoperatively; consequently, the per-protocol population included 131 patients in the no-drain group and 144 patients in the drain group. The rate of major morbidity was non-inferior in the no-drain group compared with the drain group in the intention-to-treat analysis (21 [15%] vs 29 [20%]; risk difference -4·9 percentage points [95% CI -13·8 to 4·0]; pnon-inferiority=0·0022) and the per-protocol analysis (21 [16%] vs 29 [20%]; risk difference -4·1 percentage points [-13·2 to 5·0]; pnon-inferiority=0·0045). Grade B or C POPF was observed in 16 (12%) patients in the no-drain group and in 39 (27%) patients in the drain group (risk difference -15·5 percentage points [95% CI -24·5 to -6·5]; pnon-inferiority<0·0001) in the intention-to-treat analysis. Three patients in the no-drain group died within 90 days; the cause of death in two was not considered related to the trial. The third death was a patient with an ASA score of 4 who died after sepsis and a watershed cerebral infarction at second admission, leading to multiple organ failure. No patients in the drain group died within 90 days. INTERPRETATION A no-drain policy is safe in terms of major morbidity and reduced the detection of grade B or C POPF, and should be the new standard approach in eligible patients undergoing distal pancreatectomy. FUNDING Ethicon UK (Johnson & Johnson Medical, Edinburgh, UK).
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Affiliation(s)
- Eduard A van Bodegraven
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Alberto Balduzzi
- Department of Surgery, Pancreas Institute, Verona University Hospital, Verona, Italy
| | - Tess M E van Ramshorst
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands; Department of Surgery, Poliambulanza Hospital Brescia, Brescia, Italy
| | - Giuseppe Malleo
- Department of Surgery, Pancreas Institute, Verona University Hospital, Verona, Italy
| | - Frederique L Vissers
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Jony van Hilst
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands; Department of Surgery, OLVG, Amsterdam, Netherlands
| | | | - Mohammad Abu Hilal
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Department of Surgery, Poliambulanza Hospital Brescia, Brescia, Italy
| | - Horacio J Asbun
- Division of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, FL, USA
| | - Nynke Michiels
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Bas Groot Koerkamp
- Department of Surgery and Pulmonology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Olivier R C Busch
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Freek Daams
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Misha D P Luyer
- Department of Surgery, Catharina Hospital, Eindhoven, Netherlands
| | - Marco Ramera
- Department of Surgery, Poliambulanza Hospital Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giovanni Marchegiani
- Department of Surgery, Pancreas Institute, Verona University Hospital, Verona, Italy; Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Joost M Klaase
- Department of Surgery, University Medical Center Groningen, Groningen, Netherlands
| | - I Quintus Molenaar
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht, Netherlands
| | - Matteo de Pastena
- Department of Surgery, Pancreas Institute, Verona University Hospital, Verona, Italy
| | - Gabriella Lionetto
- Department of Surgery, Pancreas Institute, Verona University Hospital, Verona, Italy
| | - Pier Giuseppe Vacca
- Department of Surgery, Pancreas Institute, Verona University Hospital, Verona, Italy
| | - Hjalmar C van Santvoort
- Department of Surgery, Regional Academic Cancer Center Utrecht, St Antonius Hospital Nieuwegein, Utrecht, Netherlands
| | | | - Daan J Lips
- Department of Surgery, Medisch Spectrum Twente, Enschede, Netherlands
| | - Mariëlle M E Coolsen
- Department of Surgery, Maastricht Universitair Medisch Centrum, Maastricht, Netherlands
| | - J Sven D Mieog
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Roberto Salvia
- Department of Surgery, Pancreas Institute, Verona University Hospital, Verona, Italy
| | - Casper H J van Eijck
- Department of Surgery and Pulmonology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Marc G Besselink
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Amsterdam, Netherlands.
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Huaroc Moquillaza E, Weiss K, Stelter J, Steinhelfer L, Lee YJ, Amthor T, Koken P, Makowski MR, Braren R, Doneva M, Karampinos DC. Accelerated liver water T 1 mapping using single-shot continuous inversion-recovery spiral imaging. NMR Biomed 2024; 37:e5097. [PMID: 38269568 DOI: 10.1002/nbm.5097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/21/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024]
Abstract
PURPOSE Liver T1 mapping techniques typically require long breath holds or long scan time in free-breathing, need correction for B 1 + inhomogeneities and process composite (water and fat) signals. The purpose of this work is to accelerate the multi-slice acquisition of liver water selective T1 (wT1) mapping in a single breath hold, improving the k-space sampling efficiency. METHODS The proposed continuous inversion-recovery (IR) Look-Locker methodology combines a single-shot gradient echo spiral readout, Dixon processing and a dictionary-based analysis for liver wT1 mapping at 3 T. The sequence parameters were adapted to obtain short scan times. The influence of fat, B 1 + inhomogeneities and TE on the estimation of T1 was first assessed using simulations. The proposed method was then validated in a phantom and in 10 volunteers, comparing it with MRS and the modified Look-Locker inversion-recovery (MOLLI) method. Finally, the clinical feasibility was investigated by comparing wT1 maps with clinical scans in nine patients. RESULTS The phantom results are in good agreement with MRS. The proposed method encodes the IR-curve for the liver wT1 estimation, is minimally sensitive to B 1 + inhomogeneities and acquires one slice in 1.2 s. The volunteer results confirmed the multi-slice capability of the proposed method, acquiring nine slices in a breath hold of 11 s. The present work shows robustness to B 1 + inhomogeneities (wT 1 , No B 1 + = 1.07 wT 1 , B 1 + - 45.63 , R 2 = 0.99 ) , good repeatability (wT 1 , 2 ° = 1 . 0 wT 1 , 1 ° - 2.14 , R 2 = 0.96 ) and is in better agreement with MRS (wT 1 = 0.92 wT 1 MRS + 103.28 , R 2 = 0.38 ) than is MOLLI (wT 1 MOLLI = 0.76 wT 1 MRS + 254.43 , R 2 = 0.44 ) . The wT1 maps in patients captured diverse lesions, thus showing their clinical feasibility. CONCLUSION A single-shot spiral acquisition can be combined with a continuous IR Look-Locker method to perform rapid repeatable multi-slice liver water T1 mapping at a rate of 1.2 s per slice without a B 1 + map. The proposed method is suitable for nine-slice liver clinical applications acquired in a single breath hold of 11 s.
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Affiliation(s)
- Elizabeth Huaroc Moquillaza
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | - Jonathan Stelter
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Lisa Steinhelfer
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | | | | | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Rickmer Braren
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Çiloğlu U, Velibey Y, Aldağ M, Güvenç TS, Naser A. Multiple aneurysms in the inferior vena cava. Am J Med Sci 2024; 367:e60-e61. [PMID: 38280672 DOI: 10.1016/j.amjms.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 01/20/2024] [Indexed: 01/29/2024]
Affiliation(s)
- Ufuk Çiloğlu
- Department of Cardiovascular Surgery, VM Medical Park Pendik Hospital, Istanbul, Turkey
| | - Yalcin Velibey
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
| | - Mustafa Aldağ
- Department of Cardiovascular Surgery, VM Medical Park Pendik Hospital, Istanbul, Turkey
| | - Tolga Sinan Güvenç
- Department of Cardiology, VM Medical Park Pendik Hospital, Istanbul, Turkey
| | - Abdulrahman Naser
- Department of Cardiology, VM Medical Park Pendik Hospital, Istanbul, Turkey
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Dickson AJ, Linsely JA, Daniel VAA, Rahul K. Sparse deep belief network coupled with extended local fuzzy active contour model-based liver cancer segmentation from abdomen CT images. Med Biol Eng Comput 2024; 62:1361-1374. [PMID: 38189903 DOI: 10.1007/s11517-023-03001-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024]
Abstract
Liver cancer from abdominal CT images must be accurately segmented for the purpose of diagnosis with treatment planning. But, the similarity in gray values between the liver and the surrounding tissues poses a challenge. To address this, a novel sparse deep belief network coupled with extended local fuzzy active contour model-based liver cancer segmentation from abdomen CT images (SDBN-ELFAC-LCS-CT) is proposed. This method incorporates dynamic adaptive pooling and residual modules in SDBN to improve the feature selection and generalization ability. Additionally, the 3D reconstruction is performed to refine segmentation results. The proposed SDBN-ELFAC-LCS-CT approach is implemented in MATLAB. The performance of the proposed SDBN-ELFAC-LCS-CT achieves dice coefficients that were up to 96.16% higher and 75.88%, 88.75%, and 71.16% lower. Volumetric overlap error compared with existing models, like basic ensembles of vanilla-style deep learning modes, increases liver segmentation from CT imageries (BEVS-LCS-CT), an incorporated 3 dimensional sparse deep belief network along enriched seagull optimization approach for liver segmentation (3DBN-ESOA-LCS-CT) and iterative convolutional encoder-decoder network and multiple scale context learning for segmenting liver (ICEDN-LCS-CT), respectively.
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Affiliation(s)
- A Joel Dickson
- Department of Electronics and Communication Engineering, Bethlahem Institute of Engineering, Karungal, Kanyakumari, 629157, Tamil Nadu, India.
| | - J Arul Linsely
- Department of Electrical and Electronics Engineering, Noorul Islam Centre for Higher Education, Kumaracoil, Kanyakumari, 629166, Tamil Nadu, India
| | - V Antony Asir Daniel
- Department of Electronics and Communication Engineering, Loyola Institute of Technology & Science, Kanyakumari, 629302, Tamil Nadu, India
| | - Kumar Rahul
- Department of Basic and Applied Science, NIFTEM, Kundli, Sonepat, 131028, India
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Fogliati A, Truty MJ. ASO Author Reflections: The Role of Neoadjuvant Chemotherapy in Invasive Intraductal Mucinous Neoplasms of the Pancreas. Ann Surg Oncol 2024; 31:2967-2968. [PMID: 38485866 PMCID: PMC10997528 DOI: 10.1245/s10434-024-15002-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 04/08/2024]
Affiliation(s)
- A Fogliati
- Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Medicine and Surgery, University of Milano Bicocca, Milano, Italy
| | - Mark J Truty
- Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
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13
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Ghuman N, Atagu N, Sachdev R, Covarrubias O, Gregg L, Brookmeyer C, Johnson P, Gomez E. 'That's just the Ovary!' and other cases of mistaken identity on CT of the female pelvis. Curr Probl Diagn Radiol 2024; 53:422-435. [PMID: 38365459 DOI: 10.1067/j.cpradiol.2024.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/16/2024] [Indexed: 02/18/2024]
Abstract
CT is often the first imaging test in female patients with lower abdominal and pelvic pain because of the wide availability of CT and differential diagnoses that span both gynecologic and gastrointestinal disease. Pathology within the female pelvis may be difficult to diagnose on CT owing to suboptimal delineation of anatomy in comparison to MRI and ultrasound. These challenges are confounded by overlapping imaging features of a wide range of gynecologic entities and can lead to diagnostic dilemmas. High value CT interpretation will direct the clinician to the best next diagnostic step as ultrasound and MRI provide superior soft tissue delineation. Other imaging modalities, laboratory investigations, or tissue sampling may be necessary to definitively characterize indeterminate lesions. In this review, we illustrate various cases of mistaken identity on CT of the female pelvis involving the ovaries, uterus, and peritoneal cavity while highlighting clinical pearls that may aid the radiologist in arriving at the correct diagnosis and avoiding potential pitfalls.
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Affiliation(s)
- Naveen Ghuman
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Norman Atagu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Rahul Sachdev
- St.Agnes Medical Center, Department of Internal Medicine, Fresno, CA, USA
| | - Oscar Covarrubias
- Medical Student, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lydia Gregg
- Johns Hopkins Department of Art as Applied to Medicine and Division of Interventional Neuroradiology, Baltimore, MD, USA
| | - Claire Brookmeyer
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pamela Johnson
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Erin Gomez
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Karlsen TH, Rutter H, Carrieri P, Zelber-Sagi S, Engebretsen E, Hutchinson S, Voigt K, Guha N, Berzigotti A, Schomerus G, Gines P, Buti M, Burra P, Manns MP, Krag A, Kleinert S. The EASL-Lancet Commission on liver health in Europe: prevention, case-finding, and early diagnosis to reduce liver-related mortality. Lancet 2024; 403:1522-1524. [PMID: 38359860 DOI: 10.1016/s0140-6736(24)00204-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Tom H Karlsen
- Department of Transplantation Medicine, Clinic of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital and University of Oslo, N-0424 Oslo, Norway; Research Institute of Internal Medicine, Clinic of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital and University of Oslo, Oslo, Norway.
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques, Sociales de la Santé, and Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Eivind Engebretsen
- Sustainable Health Unit (SUSTAINIT), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sharon Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Clinical and Protecting Health Directorate, Public Health Scotland, Glasgow, UK
| | - Kristin Voigt
- Department of Equity, Ethics and Policy and Department of Philosophy, McGill University, Quebec, Canada
| | - Neil Guha
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals, NHS Trust and the University of Nottingham, Nottingham, UK
| | - Annalisa Berzigotti
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Georg Schomerus
- Department of Psychiatry, Leipzig University Medical Center, Leipzig, Germany
| | - Pere Gines
- Liver Unit Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Maria Buti
- Liver Unit, Hospital Universitario Valle Hebron, Barcelona, Spain
| | - Patrizia Burra
- Multivisceral Transplant Unit, Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | | | - Aleksander Krag
- Centre for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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15
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Ulusoy O, Olguner M. Commentary to "Robot‑assisted laparoscopic varicocelectomy in a pediatric population''. Pediatr Surg Int 2024; 40:110. [PMID: 38634930 DOI: 10.1007/s00383-024-05698-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Oktay Ulusoy
- Department of Pediatric Surgery, Dokuz Eylül University Faculty of Medicine, Balçova, İzmir, 35340, Turkey.
| | - Mustafa Olguner
- Department of Pediatric Surgery, Dokuz Eylül University Faculty of Medicine, Balçova, İzmir, 35340, Turkey
- Division of Pediatric Urology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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16
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Ronghua W, Ji Z, Gang L, Yun Z, Xubiao N. Cystitis glandularis with concomitant Crohn's disease leading to a paroxysm of Crohn's disease with ulcerated external iliac vessels. BMC Urol 2024; 24:89. [PMID: 38632572 PMCID: PMC11022458 DOI: 10.1186/s12894-024-01470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
•we report the case of a 36-year-old female patient who presented to our hospital with a diagnosis of cystitis glandularis manifesting as a vesicovaginal fistula. She underwent cystoscopic biopsy at a local hospital, but anti-inflammatory treatment was ineffective, and the patient was experiencing low urination frequency and urgency, as well as pain. The patient underwent laparoscopic repair of a cystoscopy-confirmed vesicovaginal fistula. After surgery, the patient experienced a paroxysm of Crohn's disease with multiple small bowel fistulas and erosion of the external iliac vessels that ruptured to form an external iliac vessel small bowel fistula. The fistula was confirmed by surgical exploration, and the patient eventually died.
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Affiliation(s)
- Wu Ronghua
- Department of Urology, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Zheng Ji
- Department of Urology, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Liu Gang
- Department of Intensive Care Unit, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Zhang Yun
- Department of Cardiovascular, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China
| | - Nie Xubiao
- Department of Gastroenterology, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China.
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17
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Younossi ZM. Predicting Liver-Related Outcomes in Steatotic Liver Disease. JAMA 2024; 331:1274-1275. [PMID: 38512225 DOI: 10.1001/jama.2024.0799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Affiliation(s)
- Zobair M Younossi
- The Global NASH Council, Washington, DC
- Beatty Center for Liver and Obesity Research, Inova Health System, Falls Church, Virginia
- Center for Outcomes Research in Liver Disease, Washington, DC
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18
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Welarathna S, Velautham S, Sarasanandarajah S. Towards the establishment of national diagnostic reference levels for abdomen, KUB, and lumbar spine x-ray examinations in Sri Lanka: a multi-centric study. J Radiol Prot 2024; 44:021506. [PMID: 38537259 DOI: 10.1088/1361-6498/ad3837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
Diagnostic reference levels (DRLs) and achievable doses (ADs) provide guidance to optimise radiation doses for patients undergoing medical imaging procedures. This multi-centre study aimed to compare institutional DRLs (IDRLs) across hospitals, propose ADs and multi-centric DRLs (MCDRLs) for four common x-ray examinations in Sri Lanka, and assess the potential for dose reduction. A prospective cross-sectional study of 894 adult patients referred for abdomen anteroposterior (AP), kidney-ureter-bladder (KUB) AP, lumbar spine AP, and lumbar spine lateral (LAT) x-ray examinations was conducted. Patient demographic information (age, sex, weight, BMI) and exposure parameters (tube voltage, tube current-exposure time product) were collected. Patient dose indicators were measured in terms of kerma-area product (PKA) using a PKAmeter. IDRLs, ADs, and MCDRLs were calculated following the International Commission on Radiological Protection guidelines, with ADs and MCDRLs defined as the 50th and 75th percentiles of the median PKAdistributions, respectively. IDRL ranges varied considerably across hospitals: 1.42-2.42 Gy cm2for abdomen AP, 1.51-2.86 Gy cm2for KUB AP, 0.83-1.65 Gy cm2for lumbar spine AP, and 1.76-4.10 Gy cm2for lumbar spine LAT. The proposed ADs were 1.82 Gy cm2(abdomen AP), 2.03 Gy cm2(KUB AP), 1.27 Gy cm2(lumbar spine AP), and 2.21 Gy cm2(lumbar spine LAT). MCDRLs were 2.24 Gy cm2(abdomen AP), 2.40 Gy cm2(KUB AP), 1.43 Gy cm2(lumbar spine AP), and 2.38 Gy cm2(lumbar spine LAT). Substantial intra- and inter-hospital variations in PKAwere observed for all four examinations. Although ADs and MCDRLs in Sri Lanka were comparable to those in the existing literature, the identified intra- and inter-hospital variations underscore the need for dose reduction without compromising diagnostic information. Hospitals with high IDRLs are recommended to review and optimise their practices. These MCDRLs serve as preliminary national DRLs, guiding dose optimisation efforts by medical professionals and policymakers.
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Affiliation(s)
- Sachith Welarathna
- Department of Physics, University of Peradeniya, Peradeniya 20400, Sri Lanka
- Postgraduate Institute of Science, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Sivakumar Velautham
- Department of Physics, University of Peradeniya, Peradeniya 20400, Sri Lanka
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19
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Wei X, Zhang C, Wei W, Yang C, Zheng J, Wang K. Thoracic paravertebral nerve block combined with acupuncture for the treatment of postherpetic neuralgia in the chest and abdomen: A prospective randomized controlled trial. Medicine (Baltimore) 2024; 103:e36823. [PMID: 38579055 PMCID: PMC10994496 DOI: 10.1097/md.0000000000036823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/08/2023] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Postherpetic neuralgia (PHN) is the most common complication of varicella-zoster infection and tends to occur in older people. All patients treated with a single regimen have not achieved consistent success across all current study protocols, and multimodal combination regimens still need to be explored. METHODS A total of 111 patients with PHN were randomly divided into drug group (group A), thoracic paravertebral nerve block group (group B), thoracic paravertebral nerve block combined with acupuncture group (group C), with 37 cases in each group. Group A: received oral gabapentin capsules and external lidocaine gel plaster; group B: combined with thoracic paravertebral nerve block based on group A; group C: combined with acupuncture based on group B. The primary outcome was effective rate, and secondary outcomes included pain sensation score (numerical rating scale), SF-36 quality of life score, and sleep quality. RESULTS Before treatment, there were no significant differences in numerical rating scale value, SF-36 quality of life score, and sleep quality level among the 3 groups (P > .05). After 12 weeks of treatment, the total effective rate of treatment of patients in group C (91.43%) was higher than that in group B (77.14%), and significantly higher than that in group A (51.43%) (P < .05). CONCLUSION Based on drug treatment combined with thoracic paravertebral nerve block and acupuncture, the treatment of PHN in the elderly can quickly and effectively relieve pain, improve the quality of life of patients, and improve the quality of sleep.
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Affiliation(s)
- Xiang Wei
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chi Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Wei
- Department of Anesthesiology, Sports Hospital Affiliated to Chengdu University of Physical Education, Chengdu, China
| | - Caiqi Yang
- Department of Anesthesiology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Junyi Zheng
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kejia Wang
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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20
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Russo R, Cozzani E, D'Agostino F, Guadagno A, Parodi A. A Solitary Pinkish Nodule on the Abdomen: A Quiz. Acta Derm Venereol 2024; 104:adv18458. [PMID: 38567912 PMCID: PMC11005173 DOI: 10.2340/actadv.v104.18458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/12/2023] [Indexed: 04/05/2024] Open
Abstract
Abstract is missing (Quiz)
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Affiliation(s)
- Roberto Russo
- Department of Health Sciences, University of Genoa, Genoa, Italy; Dermatology Unit, San Martino Polyclinic Hospital, Genoa, Italy
| | - Emanuele Cozzani
- Department of Health Sciences, University of Genoa, Genoa, Italy; Dermatology Unit, San Martino Polyclinic Hospital, Genoa, Italy.
| | - Federica D'Agostino
- Department of Health Sciences, University of Genoa, Genoa, Italy; Dermatology Unit, San Martino Polyclinic Hospital, Genoa, Italy
| | | | - Aurora Parodi
- Department of Health Sciences, University of Genoa, Genoa, Italy; Dermatology Unit, San Martino Polyclinic Hospital, Genoa, Italy
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21
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Bayat F, Miller B, Park Y, Yu Z, Alexeev T, Thomas D, Stuhr K, Kavanagh B, Miften M, Altunbas C. 2D antiscatter grid and scatter sampling based CBCT method for online dose calculations during CBCT guided radiation therapy of pelvis. Med Phys 2024; 51:3053-3066. [PMID: 38043086 PMCID: PMC11008043 DOI: 10.1002/mp.16867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 10/31/2023] [Accepted: 11/15/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Online dose calculations before the delivery of radiation treatments have applications in dose delivery verification, online adaptation of treatment plans, and simulation-free treatment planning. While dose calculations by directly utilizing CBCT images are desired, dosimetric accuracy can be compromised due to relatively lower HU accuracy in CBCT images. PURPOSE In this work, we propose a novel CBCT imaging pipeline to enhance the accuracy of CBCT-based dose calculations in the pelvis region. Our approach aims to improve the HU accuracy in CBCT images, thereby improving the overall accuracy of CBCT-based dose calculations prior to radiation treatment delivery. METHODS An in-house developed quantitative CBCT pipeline was implemented to address the CBCT raw data contamination problem. The pipeline combines algorithmic data correction strategies and 2D antiscatter grid-based scatter rejection to achieve high CT number accuracy. To evaluate the effect of the quantitative CBCT pipeline on CBCT-based dose calculations, phantoms mimicking pelvis anatomy were scanned using a linac-mounted CBCT system, and a gold standard multidetector CT used for treatment planning (pCT). A total of 20 intensity-modulated treatment plans were generated for five targets, using 6 and 10 MV flattening filter-free beams, and utilizing small and large pelvis phantom images. For each treatment plan, four different dose calculations were performed using pCT images and three CBCT imaging configurations: quantitative CBCT, clinical CBCT protocol, and a high-performance 1D antiscatter grid (1D ASG). Subsequently, dosimetric accuracy was evaluated for both targets and organs at risk as a function of patient size, target location, beam energy, and CBCT imaging configuration. RESULTS When compared to the gold-standard pCT, dosimetric errors in quantitative CBCT-based dose calculations were not significant across all phantom sizes, beam energies, and treatment sites. The largest error observed was 0.6% among all dose volume histogram metrics and evaluated dose calculations. In contrast, dosimetric errors reached up to 7% and 97% in clinical CBCT and high-performance ASG CBCT-based treatment plans, respectively. The largest dosimetric errors were observed in bony targets in the large phantom treated with 6 MV beams. The trends of dosimetric errors in organs at risk were similar to those observed in the targets. CONCLUSIONS The proposed quantitative CBCT pipeline has the potential to provide comparable dose calculation accuracy to the gold-standard planning CT in photon radiation therapy for the abdomen and pelvis. These robust dose calculations could eliminate the need for density overrides in CBCT images and enable direct utilization of CBCT images for dose delivery monitoring or online treatment plan adaptations before the delivery of radiation treatments.
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Affiliation(s)
- Farhang Bayat
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Suite 1032, Mail stop F-706 Aurora, CO 80045
| | - Brian Miller
- Department of Radiation Oncology, The University of Arizona, College of Medicine, Tucson, AZ 85719
| | - Yeonok Park
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Suite 1032, Mail stop F-706 Aurora, CO 80045
| | - Zhelin Yu
- Department of Computer Science and Engineering, University of Colorado Denver, 1200 Larimer Street, Denver, CO, 80204
| | - Timur Alexeev
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Suite 1032, Mail stop F-706 Aurora, CO 80045
| | - David Thomas
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Suite 1032, Mail stop F-706 Aurora, CO 80045
| | - Kelly Stuhr
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Suite 1032, Mail stop F-706 Aurora, CO 80045
| | - Brian Kavanagh
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Suite 1032, Mail stop F-706 Aurora, CO 80045
| | - Moyed Miften
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Suite 1032, Mail stop F-706 Aurora, CO 80045
| | - Cem Altunbas
- Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Suite 1032, Mail stop F-706 Aurora, CO 80045
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Li XM, Ma FZ, Quan XY, Zhang XC, Xiao BH, Wáng YXJ. Repeatability and reproducibility comparisons of liver IVIM imaging with free-breathing or respiratory-triggered sequences. NMR Biomed 2024; 37:e5080. [PMID: 38113878 DOI: 10.1002/nbm.5080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/26/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023]
Abstract
For liver intravoxel incoherent motion (IVIM) data acquisition, respiratory-triggering (RT) MRI is commonly used, and there are strong motivations to shorten the scan duration. For the same scan duration, more b values or higher numbers of excitations can be allowed for free-breathing (FB) imaging than for RT. We studied whether FB can be used to replace RT when careful IVIM image acquisition and image processing are conducted. MRI data of 22 healthy participants were acquired using a 3.0 T scanner. Diffusion imaging was based on a single-shot spin-echo-type echo-planar sequence and 16 b values of 0, 2, 4, 7, 10, 15, 20, 30, 46, 60, 72, 100, 150, 200, 400, and 600 s/mm2 . Each subject attended two scan sessions with an interval of 10-20 days. For each scan session, a subject was scanned twice, first with RT and then with FB. The mean image acquisition time was 5.4 min for FB and 10.8 min for RT. IVIM parameters were calculated with bi-exponential model segmented fitting with a threshold b value of 60 s/mm2 , and fitting started from b = 2 s/mm2 . There was no statistically significant difference between IVIM parameters measured with FB imaging or RT imaging. Perfusion fraction ICC (intraclass correlation coefficient) for FB imaging and RT imaging in the same scan session was 0.824. For perfusion fraction, wSD (within-subject standard deviation), BA (Bland-Altman) difference, BA 95% limit, and ICC were 0.022, 0.0001, -0.0635~0.0637, and 0.687 for FB and 0.031, 0.0122, -0.0723~0.0967, and 0.611 for RT. For Dslow (×10-3 s/mm2 ), wSD, BA difference, BA 95% limit, and ICC were 0.057, 0.0268, -0.1258~0.1793, and 0.471 for FB and 0.073, -0.0078, -0.2170-0.2014, and <0.4 for RT. The Dfast coefficient of variation was 0.20 for FB imaging and 0.28 for RT imaging. All reproducibility indicators slightly favored FB imaging.
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Affiliation(s)
- Xin-Ming Li
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Fu-Zhao Ma
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xian-Yue Quan
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xu-Chang Zhang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ben-Heng Xiao
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Zhan F, Wang W, Chen Q, Guo Y, He L, Wang L. Three-Direction Fusion for Accurate Volumetric Liver and Tumor Segmentation. IEEE J Biomed Health Inform 2024; 28:2175-2186. [PMID: 38109246 DOI: 10.1109/jbhi.2023.3344392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Biomedical image segmentation of organs, tissues and lesions has gained increasing attention in clinical treatment planning and navigation, which involves the exploration of two-dimensional (2D) and three-dimensional (3D) contexts in the biomedical image. Compared to 2D methods, 3D methods pay more attention to inter-slice correlations, which offer additional spatial information for image segmentation. An organ or tumor has a 3D structure that can be observed from three directions. Previous studies focus only on the vertical axis, limiting the understanding of the relationship between a tumor and its surrounding tissues. Important information can also be obtained from sagittal and coronal axes. Therefore, spatial information of organs and tumors can be obtained from three directions, i.e. the sagittal, coronal and vertical axes, to understand better the invasion depth of tumor and its relationship with the surrounding tissues. Moreover, the edges of organs and tumors in biomedical image may be blurred. To address these problems, we propose a three-direction fusion volumetric segmentation (TFVS) model for segmenting 3D biomedical images from three perspectives in sagittal, coronal and transverse planes, respectively. We use the dataset of the liver task provided by the Medical Segmentation Decathlon challenge to train our model. The TFVS method demonstrates a competitive performance on the 3D-IRCADB dataset. In addition, the t-test and Wilcoxon signed-rank test are also performed to show the statistical significance of the improvement by the proposed method as compared with the baseline methods. The proposed method is expected to be beneficial in guiding and facilitating clinical diagnosis and treatment.
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24
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Shekhawat D, Chaiyamoon A, Cardona JJ, Lesser E, Iwanaga J, Loukas M, Killackey MT, Tubbs RS. Renal vein valves: a prevalence, microanatomical and histological study. Surg Radiol Anat 2024; 46:535-541. [PMID: 38446213 DOI: 10.1007/s00276-024-03330-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE In the modern era of robotic renal procedures and diagnostics, an even more detailed anatomical understanding than hitherto is necessary. Valves of the renal veins (RVV) have been underemphasized and have been disputed by some authors, and few textbooks describe them. The current anatomical study was performed to address such shortcomings in the literature. METHODS One hundred renal veins were studied in fifty adult formalin-fixed cadavers. Renal veins were removed from the abdomen after sectioning them flush with their entrance to the renal hilum. The inferior vena cava was then incised longitudinally and opened, and RVV were examined grossly and histologically. A classification scheme was developed and applied to our findings. RESULTS Nineteen RVVs were observed in the fifty cadavers (38%). Four (8%) valves were found on right sides and fifteen (30%) on left sides. The valves were seen as cord/band-like, folds, and single and double leaflets. Histologically, they were all extensions of the tunica intima. CONCLUSION On the basis of our study, RVV are not uncommon. They were more common on left sides, and on both sides, they were found within approximately one centimeter of the junction of the inferior vena cava and renal vein. Although the function of such valves cannot be inferred from this anatomical study, the structures of the Single leaflet valve (TS2) and Double leaflet valve (TS3) valves suggest they could prevent venous reflux from the IVC into the kidney.
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Affiliation(s)
- Devendra Shekhawat
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 South Robertson St. Suite 1300, New Orleans, LA, 70112, USA.
| | - Arada Chaiyamoon
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 South Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - Juan J Cardona
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 South Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - Emma Lesser
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 South Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 South Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - Marios Loukas
- Departmentof Anatomical Sciences, St. George's University, St. George's, West Indies, Grenada
| | - Mary T Killackey
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 South Robertson St. Suite 1300, New Orleans, LA, 70112, USA
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
- Departmentof Anatomical Sciences, St. George's University, St. George's, West Indies, Grenada
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
- Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
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25
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Westphal K. Gastritis oder Reizmagen, Dyspepsie oder Reflux? MMW Fortschr Med 2024; 166:12-15. [PMID: 38637368 DOI: 10.1007/s15006-024-3846-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
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26
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Gruenberg B, Crane G, Arnold DH, Harrison NJ, Levine M. Yield of abdominal radiographs in children with suspected intussusception; rate of pneumoperitoneum and other abdominal pathology. Am J Emerg Med 2024; 78:18-21. [PMID: 38181541 DOI: 10.1016/j.ajem.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/28/2023] [Accepted: 12/14/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVES Ultrasound is the criterion standard imaging modality for the diagnosis of intussusception. However, to our knowledge the utility of abdominal radiographs to concurrently screen for pneumoperitoneum or other abdominal pathology that could have a similar presentation has not been studied. Our institutional protocol requires the performance of AP supine and left lateral decubitus views of the abdomen prior to ultrasound evaluation for intussusception, providing an opportunity to examine the yield of abdominal radiographs in this setting. Our primary objective was to determine the rate of pneumoperitoneum on screening abdominal radiographs in children undergoing evaluation for intussusception. Our secondary objective was to determine the rate that other clinically significant pathology is found on these screening abdominal radiographs. METHODS We performed a retrospective chart review of all patients under 6 years of age who had any imaging ordered in our large urban pediatric emergency department to evaluate for suspected intussusception during the calendar years 2018-2020. RESULTS 1115 patient encounters met our inclusion criteria. Among 1090 who had screening abdominal radiographs, 82 (8%) had findings concerning for intussusception. Of those not concerning for intussusception, 635 (58%) were read as normal, 263 (24%) showed moderate to large stool burden, 107 (10%) showed generalized bowel distention, and 22 (2%) showed abnormal gastric distention. Individually the remainder of all other findings compromised <1% of encounters and included radiopaque foreign body (8), intraabdominal calcification (4), pneumonia/effusion (3), pneumatosis intestinalis, abdominal mass (2), diaphragmatic hernia (1), rib fracture (1), appendicolith (1), feeding tube malposition (1), and bowel wall thickening (1). In one encounter the patient had a bowel perforation with pneumoperitoneum present secondary to ingestion of multiple magnets. CONCLUSIONS Our study indicates that radiograph-detected pneumoperitoneum is rare in children with suspected intussusception. Constipation is the most common abnormal finding on screening radiographs. Other findings occur in approximately 15% of total cases, some of which require further workup.
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Affiliation(s)
- Blake Gruenberg
- Vanderbilt University Medical Center, Department of Pediatrics, Division of Pediatric Emergency Medicine, 2200 Children's Way, Nashville, TN, 37232, USA.
| | - Gabriella Crane
- Vanderbilt University Medical Center, Department of Radiology, Division of Pediatric Radiology, 2200 Children's Way, Nashville, TN, 37232, USA
| | - Donald H Arnold
- Vanderbilt University Medical Center, Department of Pediatrics, Division of Pediatric Emergency Medicine, 2200 Children's Way, Nashville, TN, 37232, USA
| | - Noah J Harrison
- Vanderbilt University School of Medicine, 1161 21st Ave S # D3300, Nashville, TN, 37232, USA
| | - Marla Levine
- Vanderbilt University Medical Center, Department of Pediatrics, Division of Pediatric Emergency Medicine, 2200 Children's Way, Nashville, TN, 37232, USA
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Ruli T, Weber F, Baldwin N. Cough With a Pop: A Rare Case of Acquired Abdominal Intercostal Hernia. Am J Gastroenterol 2024; 119:606. [PMID: 38146870 DOI: 10.14309/ajg.0000000000002643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Affiliation(s)
- Thomas Ruli
- Internal Medicine Residency Program, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Frederick Weber
- Division of Gastroenterology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nicholas Baldwin
- Division of Gastroenterology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Liu L, Shen L, Johansson A, Balter JM, Cao Y, Vitzthum L, Xing L. Volumetric MRI with sparse sampling for MR-guided 3D motion tracking via sparse prior-augmented implicit neural representation learning. Med Phys 2024; 51:2526-2537. [PMID: 38014764 PMCID: PMC10994763 DOI: 10.1002/mp.16845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/22/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Volumetric reconstruction of magnetic resonance imaging (MRI) from sparse samples is desirable for 3D motion tracking and promises to improve magnetic resonance (MR)-guided radiation treatment precision. Data-driven sparse MRI reconstruction, however, requires large-scale training datasets for prior learning, which is time-consuming and challenging to acquire in clinical settings. PURPOSE To investigate volumetric reconstruction of MRI from sparse samples of two orthogonal slices aided by sparse priors of two static 3D MRI through implicit neural representation (NeRP) learning, in support of 3D motion tracking during MR-guided radiotherapy. METHODS A multi-layer perceptron network was trained to parameterize the NeRP model of a patient-specific MRI dataset, where the network takes 4D data coordinates of voxel locations and motion states as inputs and outputs corresponding voxel intensities. By first training the network to learn the NeRP of two static 3D MRI with different breathing motion states, prior information of patient breathing motion was embedded into network weights through optimization. The prior information was then augmented from two motion states to 31 motion states by querying the optimized network at interpolated and extrapolated motion state coordinates. Starting from the prior-augmented NeRP model as an initialization point, we further trained the network to fit sparse samples of two orthogonal MRI slices and the final volumetric reconstruction was obtained by querying the trained network at 3D spatial locations. We evaluated the proposed method using 5-min volumetric MRI time series with 340 ms temporal resolution for seven abdominal patients with hepatocellular carcinoma, acquired using golden-angle radial MRI sequence and reconstructed through retrospective sorting. Two volumetric MRI with inhale and exhale states respectively were selected from the first 30 s of the time series for prior embedding and augmentation. The remaining 4.5-min time series was used for volumetric reconstruction evaluation, where we retrospectively subsampled each MRI to two orthogonal slices and compared model-reconstructed images to ground truth images in terms of image quality and the capability of supporting 3D target motion tracking. RESULTS Across the seven patients evaluated, the peak signal-to-noise-ratio between model-reconstructed and ground truth MR images was 38.02 ± 2.60 dB and the structure similarity index measure was 0.98 ± 0.01. Throughout the 4.5-min time period, gross tumor volume (GTV) motion estimated by deforming a reference state MRI to model-reconstructed and ground truth MRI showed good consistency. The 95-percentile Hausdorff distance between GTV contours was 2.41 ± 0.77 mm, which is less than the voxel dimension. The mean GTV centroid position difference between ground truth and model estimation was less than 1 mm in all three orthogonal directions. CONCLUSION A prior-augmented NeRP model has been developed to reconstruct volumetric MRI from sparse samples of orthogonal cine slices. Only one exhale and one inhale 3D MRI were needed to train the model to learn prior information of patient breathing motion for sparse image reconstruction. The proposed model has the potential of supporting 3D motion tracking during MR-guided radiotherapy for improved treatment precision and promises a major simplification of the workflow by eliminating the need for large-scale training datasets.
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Affiliation(s)
- Lianli Liu
- Department of Radiation Oncology, Stanford University, Palo Alto, California, USA
| | - Liyue Shen
- Department of Electrical Engineering, Stanford University, Palo Alto, California, USA
| | - Adam Johansson
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Immunology Genetics and pathology, Uppsala University, Uppsala, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - James M Balter
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yue Cao
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lucas Vitzthum
- Department of Radiation Oncology, Stanford University, Palo Alto, California, USA
| | - Lei Xing
- Department of Radiation Oncology, Stanford University, Palo Alto, California, USA
- Department of Electrical Engineering, Stanford University, Palo Alto, California, USA
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29
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Smiles S, Stante C, Ruda M, Magnanelli V, Palmieri FI, Cheistwer A, Mirón L, Neyro S. Abdominal tuberculosis in pediatrics: A case report. ARCH ARGENT PEDIATR 2024; 122:e202310049. [PMID: 37725752 DOI: 10.5546/aap.2023-10049.eng] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Tuberculosis is an infectious disease which most commonly compromises the respiratory system, whereas abdominal involvement is rare, thus its diagnosis is a challenge. The clinical manifestations of abdominal tuberculosis as well as its physical examination findings are usually non-specific and, frequently, similar to those of other diseases, so it is critical to consider abdominal tuberculosis among the differential diagnoses. Here we report the clinical case of a 15-year-old male patient hospitalized for a prolonged febrile syndrome associated with abdominal pain, diarrhea, night sweats, and weight loss.
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Affiliation(s)
- Sara Smiles
- Unit 6 of Clinical Pediatrics; Hospital General de Niños Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - Carolina Stante
- Unit 6 of Clinical Pediatrics; Hospital General de Niños Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - Martín Ruda
- Unit 6 of Clinical Pediatrics; Hospital General de Niños Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - Vanina Magnanelli
- Unit 6 of Clinical Pediatrics; Hospital General de Niños Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - Florencia I Palmieri
- Unit 6 of Clinical Pediatrics; Hospital General de Niños Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - Ariel Cheistwer
- Unit 6 of Clinical Pediatrics; Hospital General de Niños Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - Lorena Mirón
- Unit 6 of Clinical Pediatrics; Hospital General de Niños Ricardo Gutiérrez, City of Buenos Aires, Argentina
| | - Silvina Neyro
- Department of Phthisiology; Hospital General de Niños Ricardo Gutiérrez, City of Buenos Aires, Argentina
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30
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Theodorsen NM, Bø K, Fersum KV, Haukenes I, Moe-Nilssen R. Pregnant women may exercise both abdominal and pelvic floor muscles during pregnancy without increasing the diastasis recti abdominis: a randomised trial. J Physiother 2024; 70:142-148. [PMID: 38472049 DOI: 10.1016/j.jphys.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/15/2024] [Accepted: 02/07/2024] [Indexed: 03/14/2024] Open
Abstract
QUESTION What is the effect of a 12-week abdominal and pelvic floor muscle exercise program during pregnancy on the inter-recti distance (IRD) in women with diastasis recti abdominis immediately after the 12-week intervention period and at follow-up 6 weeks postpartum? DESIGN An exploratory, parallel-group, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. PARTICIPANTS Ninety-six pregnant women aged ≥ 18 years, either primigravida or multigravida, in gestation week 24 with an IRD of ≥ 28 mm measured at rest and/or a protrusion on initial assessment. INTERVENTION The experimental group participated in a 12-week abdominal and pelvic floor muscle exercise program during pregnancy. The control group received no intervention. OUTCOME MEASURES Change (mm) in IRD 2 cm above and below the umbilicus at rest from pre-intervention to immediately post-intervention and to 6 weeks follow-up measured with ultrasonography. RESULTS The IRD increased for both groups from baseline to immediately after the intervention and decreased from after the intervention to the follow-up at 6 weeks postpartum. The IRD was smallest for both groups at the follow-up. At 2 cm above the umbilicus, the intervention effect was 2 mm (95% CI -2 to 7) immediately after the intervention and -1 mm (95% CI -4 to 3) at follow-up. At 2 cm below the umbilicus, the intervention effect was -5 mm (95% CI -10 to 0) immediately after the intervention and 0 mm (95% CI -4 to 4) at follow-up. CONCLUSION Abdominal and pelvic floor muscle training during pregnancy have a negligible effect on the IRD immediately after 12 weeks of intervention and at 6 weeks post-partum. REGISTRATION NCT04960800.
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Affiliation(s)
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway; Akershus University Hospital, Department of Obstetrics and Gynecology, Lørenskog, Norway
| | - Kjartan Vibe Fersum
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Inger Haukenes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rolf Moe-Nilssen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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31
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Jang BK. Correspondence on Letter regarding "Both liver parenchymal and non-parenchymal cells express JCAD proteins under various circumstances". Clin Mol Hepatol 2024; 30:297-298. [PMID: 38606426 PMCID: PMC11016488 DOI: 10.3350/cmh.2024.0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Byoung Kuk Jang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
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32
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Xie L, Zhang L, Chen H, Yang YY, Wu J. Both liver parenchymal and non-parenchymal cells express JCAD protein under various circumstances. Clin Mol Hepatol 2024; 30:279-280. [PMID: 38503552 PMCID: PMC11016501 DOI: 10.3350/cmh.2024.0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 03/21/2024] Open
Affiliation(s)
- Li Xie
- Department of Medical Microbiology & Parasitology, MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China
| | - Li Zhang
- Department of Medical Microbiology & Parasitology, MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China
| | - Hui Chen
- Department of Medical Microbiology & Parasitology, MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China
| | - Yong-Yu Yang
- Department of Medical Microbiology & Parasitology, MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China
| | - Jian Wu
- Department of Medical Microbiology & Parasitology, MOE/NHC/CAMS Key Laboratory of Medical Molecular Virology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China
- Department of Gastroenterology & Hepatology, Zhongshan Hospital of Fudan University, Shanghai, China
- Shanghai Institute of Liver Diseases, Fudan University Shanghai Medical College, Shanghai, China
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33
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Rezaee-Zavareh MS, Kim N, Yang JD. Starting the journey: Understanding the roles of complement proteins in liver diseases through mendelian randomization. Clin Mol Hepatol 2024; 30:150-153. [PMID: 38385196 PMCID: PMC11016470 DOI: 10.3350/cmh.2024.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 02/23/2024] Open
Affiliation(s)
| | - Naomy Kim
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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34
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Smith-Bindman R, Kang T, Chu PW, Wang Y, Stewart C, Das M, Duong PA, Cervantes L, Lamba R, Lee RK, MacLeod F, Kasraie N, Neill R, Pike P, Roehm J, Schindera S, Chung R, Delman BN, Jeukens CRLPN, Starkey LJ, Szczykutowicz TP. Large variation in radiation dose for routine abdomen CT: reasons for excess and easy tips for reduction. Eur Radiol 2024; 34:2394-2404. [PMID: 37735276 PMCID: PMC10957641 DOI: 10.1007/s00330-023-10076-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 06/22/2023] [Accepted: 06/30/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To characterize the use and impact of radiation dose reduction techniques in actual practice for routine abdomen CT. METHODS We retrospectively analyzed consecutive routine abdomen CT scans in adults from a large dose registry, contributed by 95 hospitals and imaging facilities. Grouping exams into deciles by, first, patient size, and second, size-adjusted dose length product (DLP), we summarized dose and technical parameters and estimated which parameters contributed most to between-protocols dose variation. Lastly, we modeled the total population dose if all protocols with mean size-adjusted DLP above 433 or 645 mGy-cm were reduced to these thresholds. RESULTS A total of 748,846 CTs were performed using 1033 unique protocols. When sorted by patient size, patients with larger abdominal diameters had increased dose and effective mAs (milliampere seconds), even after adjusting for patient size. When sorted by size-adjusted dose, patients in the highest versus the lowest decile in size-adjusted DLP received 6.4 times the average dose (1680 vs 265 mGy-cm) even though diameter was no different (312 vs 309 mm). Effective mAs was 2.1-fold higher, unadjusted CTDIvol 2.9-fold, and phase 2.5-fold for patients in the highest versus lowest size-adjusted DLP decile. There was virtually no change in kV (kilovolt). Automatic exposure control was widely used to modulate mAs, whereas kV modulation was rare. Phase was the strongest driver of between-protocols variation. Broad adoption of optimized protocols could result in total population dose reductions of 18.6-40%. CONCLUSION There are large variations in radiation doses for routine abdomen CT unrelated to patient size. Modification of kV and single-phase scanning could result in substantial dose reduction. CLINICAL RELEVANCE Radiation dose-optimization techniques for routine abdomen CT are routinely under-utilized leading to higher doses than needed. Greater modification of technical parameters and number of phases could result in substantial reduction in radiation exposure to patients. KEY POINTS • Based on an analysis of 748,846 routine abdomen CT scans in adults, radiation doses varied tremendously across patients of the same size and optimization techniques were routinely under-utilized. • The difference in observed dose was due to variation in technical parameters and phase count. Automatic exposure control was commonly used to modify effective mAs, whereas kV was rarely adjusted for patient size. Routine abdomen CT should be performed using a single phase, yet multi-phase was common. • kV modulation by patient size and restriction to a single phase for routine abdomen indications could result in substantial reduction in radiation doses using well-established dose optimization approaches.
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Affiliation(s)
- Rebecca Smith-Bindman
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16Th Street, San Francisco, CA, 94158, USA.
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois Street, San Francisco, CA, 94158, USA.
| | - Taewoon Kang
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16Th Street, San Francisco, CA, 94158, USA
| | - Philip W Chu
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16Th Street, San Francisco, CA, 94158, USA
| | - Yifei Wang
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16Th Street, San Francisco, CA, 94158, USA
| | - Carly Stewart
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16Th Street, San Francisco, CA, 94158, USA
| | - Marco Das
- Department of Diagnostic and Interventional Radiology, Helios Hospital Duisburg, An Der Abtei 7-11, 47166, Duisburg, Germany
| | - Phuong-Anh Duong
- Department of Radiology, New York University Langone, 6 Ohio Drive, Lake Success, NY, 11042, USA
| | - Luisa Cervantes
- Department of Radiology, Nicklaus Children's Hospital, 3100 SW 62Nd Avenue, Miami, FL, 33155, USA
| | - Ramit Lamba
- Department of Radiology, University of California Davis, 4860 Y Street, Suite 3100, Sacramento, CA, 95817, USA
| | - Ryan K Lee
- Department of Radiology, Ground Floor, Einstein Healthcare Network, 5501 Old York Road, Levy Bldg, Philadelphia, PA, 19141, USA
| | - Fiona MacLeod
- Department of Radiology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - Nima Kasraie
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Rebecca Neill
- Department of Radiology and Imaging Sciences, Emory University, 1365 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Pavlina Pike
- Huntsville Hospital, 101 Sivley Rd SW, Huntsville, AL, 35801, USA
| | | | - Sebastian Schindera
- Institute of Radiology, Kantonsspital Aarau AG, Tellstrasse 25, 5001, Aarau, Switzerland
| | - Robert Chung
- Department of Demography, University of California Berkeley, 310 Social Sciences Building, Berkeley, CA, 94720-2120, USA
| | - Bradley N Delman
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029-6574, USA
| | - Cécile R L P N Jeukens
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25 6229 HX, PO Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - L Jay Starkey
- Department of Radiology, St Luke's International Hospital, 9-1 Akashicho, Tokyo, 104-8560, Chuo City, Japan
| | - Timothy P Szczykutowicz
- Departments of Radiology, Medical Physics, and Biomedical Engineering, University of Wisconsin Madison, Madison, WI, USA
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35
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Xu J, Yang B, Liu J, Yang Y. Inferior vena cava tumor invading bilateral renal veins. Asian J Surg 2024; 47:1943-1944. [PMID: 38228456 DOI: 10.1016/j.asjsur.2023.12.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/25/2023] [Indexed: 01/18/2024] Open
Affiliation(s)
- Jin Xu
- Second Affiliated Hospital of Kunming Medical University, Yunnan Province, China
| | - Bin Yang
- Second Affiliated Hospital of Kunming Medical University, Yunnan Province, China
| | - Jianhe Liu
- Second Affiliated Hospital of Kunming Medical University, Yunnan Province, China.
| | - Yalin Yang
- Second Affiliated Hospital of Kunming Medical University, Yunnan Province, China.
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36
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Soma G, DeGuardi J, Iqbal AU, Leviter J, Riera A. Is it Smoke and Mirrors? Detection of Inferior Vena Cava Thrombus by Focused Cardiac Ultrasound. Pediatr Emerg Care 2024; 40:323-325. [PMID: 38227793 DOI: 10.1097/pec.0000000000003107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
ABSTRACT Inferior vena cava assessment is a standard component of focused cardiac ultrasound, traditionally used to qualify intravascular volume status. In this case series, we demonstrate that pediatric focused cardiac ultrasound can also diagnose inferior vena cava thrombi and masses, while distinguishing them from a potentially benign smoke-like artifact.
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Affiliation(s)
- Gauthami Soma
- From the Yale School of Medicine, Department of Pediatrics, Section of Emergency Medicine, New Haven, CT
| | | | - Ammarah U Iqbal
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Julie Leviter
- From the Yale School of Medicine, Department of Pediatrics, Section of Emergency Medicine, New Haven, CT
| | - Antonio Riera
- From the Yale School of Medicine, Department of Pediatrics, Section of Emergency Medicine, New Haven, CT
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37
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Chen X, Huang S, Xu Q, Lin H. Primary clear-cell adenocarcinoma surrounding the female urethra: A case report and review of literature. Asian J Surg 2024; 47:2006-2007. [PMID: 38220522 DOI: 10.1016/j.asjsur.2023.12.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/29/2023] [Indexed: 01/16/2024] Open
Affiliation(s)
- Xiaofeng Chen
- Department of Urology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Sixing Huang
- Department of Urology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Qianhui Xu
- Department of Gastirc, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Haili Lin
- Department of Urology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.
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38
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Wakabayashi N, Kimura R, Kuwatani M, Matsui A, Ino N, Mitsuhashi T, Kishi K, Tsuneta S, Nakagawa J, Nishioka N, Sakamoto K, Kato F, Shimizu A, Hirano S, Kudo K. Gastrointestinal: Solid pseudopapillary neoplasm of the pancreas with high-grade malignant transformation. J Gastroenterol Hepatol 2024; 39:618-619. [PMID: 38224676 DOI: 10.1111/jgh.16455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/11/2023] [Indexed: 01/17/2024]
Affiliation(s)
- N Wakabayashi
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - R Kimura
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - M Kuwatani
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan
| | - A Matsui
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - N Ino
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - T Mitsuhashi
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - K Kishi
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan
| | - S Tsuneta
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - J Nakagawa
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - N Nishioka
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - K Sakamoto
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - F Kato
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
| | - A Shimizu
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - S Hirano
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - K Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Chen K, Zhang J, Beeraka NM, Lu P. Thoracic-abdominal recession to preserve thickness of adipose layer in radical mastectomy patients: A clinically relevant anatomical pocket. J Plast Reconstr Aesthet Surg 2024; 91:164-166. [PMID: 38417392 DOI: 10.1016/j.bjps.2024.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/12/2023] [Accepted: 02/04/2024] [Indexed: 03/01/2024]
Affiliation(s)
- Kuo Chen
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshedong Str., Zhengzhou, Henan 450052, China
| | - Jin Zhang
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Narasimha M Beeraka
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow 119991, Russia; Raghavendra Institute of Pharmaceutical Education and Research (RIPER), Anantapuramu, Chiyyedu, Andhra Pradesh 515721, India; Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, 1044 W. Walnut Street, R4-168, Indianapolis, IN 46202, USA
| | - Pengwei Lu
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshedong Str., Zhengzhou, Henan 450052, China.
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Bakula B, Stanić G, Bakula M, Kodrić F. Enteroenteric intussusception caused by a small bowel metastatic cutaneous melanoma. Rev Esp Enferm Dig 2024; 116:220-222. [PMID: 37539519 DOI: 10.17235/reed.2023.9876/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Unlike in children, intussusception is very rare in adults and accounts for only 1% of ileus in that population. While intussusception in children is most often idiopathic, in adults the cause of intussusception in most cases is tumor and most often metastatic adenocarcinoma. It is an extremely rare phenomenon for intestinal melanoma metastasis to be the cause of intussusception and has been described in the literature so far only in a limited number of case reports. 41-year-old female patient was admitted to the emergency department with a clinical picture of ileus. The patient had a melanoma excision on her back five years ago, for which chemotherapy and radiotherapy were carried out. An MSCT of the abdomen was performed, which indicated an obstructive ileus of the small intestine with a typical sign of intussusception (target sign). Upon explorative laparotomy enteroenteric intussusception was found with an invaginated segment of the ileum in a length of about 20 cm. When the intussuscepted segment was reduced, a black tumor the size of a plum was verified as a leading point. Histological analysis indicated metastatic cutaneous melanoma with foci of melanocytes underneath normal intestinal epithelium.
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Affiliation(s)
| | | | - Maja Bakula
- Ophtalmology, University Hospital Center Zagreb, Croatia
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Lerut J. Liver transplantation and liver resection as alternative treatments for primary hepatobiliary and secondary liver tumors: Competitors or allies? Hepatobiliary Pancreat Dis Int 2024; 23:111-116. [PMID: 38195351 DOI: 10.1016/j.hbpd.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/28/2023] [Indexed: 01/11/2024]
Affiliation(s)
- Jan Lerut
- Institute for Experimental and Clinical Research (IREC), Université catholique Louvain (UCL), Avenue Hippocrate 56, 1200 Woluwe Saint Pierre, Brussels, Belgium.
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Bursać D, Zadro M, Haramina S, Bošnjak DC, Tučkar N, Kuna K. Unusual presentation of late-stage ectopic tubal pregnancy (19 weeks' gestation): Case report and literature review. Eur J Obstet Gynecol Reprod Biol 2024; 295:150-152. [PMID: 38359636 DOI: 10.1016/j.ejogrb.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/23/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
Ectopic pregnancy is a medical condition in which a fertilized egg takes an unexpected detour away from the uterine cavity and the fallopian tube becomes a popular host, with the ampulla being the prime location. However, it can occur in other areas such as cervix, ovaries, or abdomen. The most common risk factors are pelvic inflammatory disease, previous pelvic or abdominal surgery, abnormal anatomy of genital organs, endometriosis, previous ectopic pregnancies, assisted reproductive technologies, endocrine disorders, and even the subtle influence of low-dose progestins from contraceptives. We will present a rare case of unrecognized late-stage tubal ectopic pregnancy. The following case report is of a 25-year-old Caucasian female patient (G2, P0) who presented to the emergency department with a 24-hour abdominal pain syndrome. The patient did not have a gynecological examination for this reason. During the examination, taking into account the clinical and ultrasound findings, a suspicion of pregnancy in a bicornuate uterus was raised, and an MRI of the pelvis was performed. MRI showed ectopic pregnancy in the left fallopian tube with a properly developed fetus that corresponded to a gestation of 19 weeks. An emergency laparotomy was performed and the left fallopian tube with the fetus was removed. The early and late course of recovery went smoothly. The patient was discharged after adequate clinical development.
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Affiliation(s)
- Danijel Bursać
- Department of Obstetrics and Gynecology, University Hospital Merkur, Zagreb, Croatia; University of North, University Center Varaždin, Croatia
| | - Matilda Zadro
- Department of Obstetrics and Gynecology, University Hospital Sisters of Charity, Zagreb, Croatia
| | - Suzana Haramina
- Department of Obstetrics and Gynecology, University Hospital Sisters of Charity, Zagreb, Croatia
| | - Diana Culej Bošnjak
- Department of Obstetrics and Gynecology, University Hospital Merkur, Zagreb, Croatia.
| | - Neven Tučkar
- Department of Obstetrics and Gynecology, University Hospital Sisters of Charity, Zagreb, Croatia; Faculty of Kinesiology, University of Zagreb, Croatia
| | - Krunoslav Kuna
- Department of Obstetrics and Gynecology, University Hospital Sisters of Charity, Zagreb, Croatia
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Shi Z, Kong F, Cheng M, Cao H, Ouyang S, Cao Q. Multi-energy CT material decomposition using graph model improved CNN. Med Biol Eng Comput 2024; 62:1213-1228. [PMID: 38159238 DOI: 10.1007/s11517-023-02986-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024]
Abstract
In spectral CT imaging, the coefficient image of the basis material obtained by the material decomposition technique can estimate the tissue composition, and its accuracy directly affects the disease diagnosis. Although the precision of material decomposition is increased by employing convolutional neural networks (CNN), extracting the non-local features from the CT image is restricted using the traditional CNN convolution operator. A graph model built by multi-scale non-local self-similar patterns is introduced into multi-material decomposition (MMD). We proposed a novel MMD method based on graph edge-conditioned convolution U-net (GECCU-net) to enhance material image quality. The GECCU-net focuses on developing a multi-scale encoder. At the network coding stage, three paths are applied to capture comprehensive image features. The local and non-local feature aggregation (LNFA) blocks are designed to integrate the local and non-local features from different paths. The graph edge-conditioned convolution based on non-Euclidean space excavates the non-local features. A hybrid loss function is defined to accommodate multi-scale input images and avoid over-smoothing of results. The proposed network is compared quantitatively with base CNN models on the simulated and real datasets. The material images generated by GECCU-net have less noise and artifacts while retaining more information on tissue. The Structural SIMilarity (SSIM) of the obtained abdomen and chest water maps reaches 0.9976 and 0.9990, respectively, and the RMSE reduces to 0.1218 and 0.4903 g/cm3. The proposed method can improve MMD performance and has potential applications.
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Affiliation(s)
- Zaifeng Shi
- School of Microelectronics, Tianjin University, Tianjin, 300072, China.
- Tianjin Key Laboratory of Imaging and Sensing Microelectronic Technology, Tianjin, China.
| | - Fanning Kong
- School of Microelectronics, Tianjin University, Tianjin, 300072, China
| | - Ming Cheng
- School of Microelectronics, Tianjin University, Tianjin, 300072, China
| | - Huaisheng Cao
- School of Microelectronics, Tianjin University, Tianjin, 300072, China
| | - Shunxin Ouyang
- School of Microelectronics, Tianjin University, Tianjin, 300072, China
| | - Qingjie Cao
- School of Mathematical Sciences, Tianjin Normal University, Tianjin, 300387, China
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Ma YQ, Bi XR, Zhan WP, Ma YT. Bronchogenic cyst located between abdominal aorta and the lesser curvature of stomach. Asian J Surg 2024; 47:1965-1967. [PMID: 38262794 DOI: 10.1016/j.asjsur.2023.12.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/25/2023] [Indexed: 01/25/2024] Open
Affiliation(s)
- Yu Qi Ma
- The First Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou, China
| | - Xin Ran Bi
- The First Clinical Medical College, Gansu University of Traditional Chinese Medicine, Lanzhou, China
| | - Wei Peng Zhan
- Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Yun Tao Ma
- Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China.
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Serenari M, Lenzi J, Ricci C, Odaldi F, Maroni L, Laurenzi A, Prosperi E, Bonatti C, Fallani G, Caputo F, Rottoli M, Ravaioli M, Cescon M. The Importance of Multiorgan Procurement in the Improvement of Residents' Open Surgical Skills. J Surg Res 2024; 296:441-446. [PMID: 38320363 DOI: 10.1016/j.jss.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION The multiorgan procurement (MOP) represents a chance for the general surgery resident to learn the fundamental steps of open abdominal surgery. The objective of this study was to evaluate the impact of MOP on the residents' open surgical skills. METHODS Residents' surgical skills were assessed during a 6-month transplant rotation (October 2020-March 2021) using a modified Objective Structured Assessment of Technical Skills with the global rating scale. The surgeries were self-assessed by residents and tutors based on 9 specific steps (SS) and 4 general skills (GS). Each item was rated from 1 (poor) to 5 (excellent) with a maximum score of 45 points for SS and 20 for GS. A crossed-effects linear regression analysis was performed both to evaluate any associations between GS/SS scores and some prespecified covariates, and to study differences in the assessments performed by residents and tutors. RESULTS Residents actively participated in a total of 59 procurements. In general, there were no significant differences in SS/GS mean scorings between residents (n = 15) and tutors (n = 5). There was a significantly positive association between mean GS/SS scorings and the number of donor surgeries performed (at least 5). Comparing the evaluations of the tutors with the residents, this significance was retained only when scorings were assigned by the tutors. CONCLUSIONS MOP was shown to improve basic open surgical skills among residents. Awareness of the utility of a clinical rotation in transplant surgery should be raised also on an institutional level.
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Affiliation(s)
- Matteo Serenari
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy.
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Claudio Ricci
- Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy; Division of Pancreatic Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Federica Odaldi
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Maroni
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Laurenzi
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Enrico Prosperi
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Chiara Bonatti
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Guido Fallani
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Francesca Caputo
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Matteo Rottoli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy; Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Matteo Ravaioli
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Matteo Cescon
- Hepato-biliary and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
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Alventosa Mateu C, Vilar Gimeno A, Pérez Álvarez I, Carbonell Zamorano J, Castelló Miralles I, Latorre Sánchez M, José Urquijo Ponce J, Martínez Leandro E, Terrádez Mas L, Diago M. Extrarenal fibrillary glomerulonephritis as an unknown etiology of advanced liver disease. Gastroenterol Hepatol 2024; 47:381-383. [PMID: 37562769 DOI: 10.1016/j.gastrohep.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/03/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Affiliation(s)
| | | | | | - Javier Carbonell Zamorano
- Servicio de Anatomía Patológica, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | | | | | | | | | - Liria Terrádez Mas
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Valencia, España
| | - Moisés Diago
- Unidad de Hepatología, Servicio de Patología Digestiva
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Cristaudo AT, Hitos K, Gunnarsson R, de Costa A, Yuen A. Re: Development and validation of a multivariable prediction model in open abdomen patients for entero-atmospheric fistula. ANZ J Surg 2024; 94:769-770. [PMID: 38156742 DOI: 10.1111/ans.18846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Adam T Cristaudo
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Research Centre for Evaluation of Surgical Outcomes, Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Kerry Hitos
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Research Centre for Evaluation of Surgical Outcomes, Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Ronny Gunnarsson
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Sweden
- Primary Health Care Clinic for Homeless People, Gothenburg, Sweden
| | - Alan de Costa
- College of Medicine & Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Alex Yuen
- Gold Coast University Hospital, Southport, Queensland, Australia
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Manjatika AT, Mazengenya P, Davimes JG. Bilateral duplicated inferior vena cava associated with aberrant internal iliac and gonadal veins: A case-based narrative review. Ann Anat 2024; 253:152223. [PMID: 38295909 DOI: 10.1016/j.aanat.2024.152223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/09/2023] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The left side anterior retroperitoneal approach is preferred for the management of lumbosacral spine disorders as there is reduced risk for vascular injury. The presence of multiple and uncommon venous variations on either side of the spine, like the bilateral duplicated inferior vena cava (DIVC), may complicate surgery in this region. The current study describes two rare cases of bilateral duplicated inferior vena cava associated with internal iliac and gonadal veins. METHODS The cases were identified during routine human dissections of the posterior abdominal wall of 89 (45 males, 44 females) individuals. The course, relations and morphometry of each duplicated inferior vena cava were examined and recorded. RESULTS Two (2.2%) of the 89 (1 male, 1 female) dissected individuals showed the presence of bilateral duplicated infrarenal segments of the inferior vena cava. In both cases, the pre-aortic trunk (vein) was the largest and the left inferior vena cava was the smallest. Both cases of bilateral DIVC presented with anomalous interiliac communicating veins, internal iliac veins, and drainage sites of the left gonadal veins. CONCLUSIONS The duplicated inferior vena cava may present with associated venous anomalies like those related to the gonadal and internal iliac veins. Knowledge of the duplicated inferior vena cava and its associated venous anomalies may be essential for accurately identifying and diagnosing vascular dysfunction and improving radiological interpretation across multiple surgical specialities.
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Affiliation(s)
- Arthur Tsalani Manjatika
- School of Anatomical Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa; School of Life Sciences, Anatomy Division, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Pedzisai Mazengenya
- College of Medicine, Ajman University, Ajman, United Arab Emirates; Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates; Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa.
| | - Joshua Gabriel Davimes
- School of Anatomical Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
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Jhajharia A, Singh S, Chaudhary M, Ameta M, Ashdhir P, Nijhawan S. Efficacy and Rationale of Endoscopic Ultrasound-Guided Thrombin Injection in Visceral Artery Pseudoaneurysm Not Amenable to Angioembolization. Pancreas 2024; 53:e330-e337. [PMID: 38345925 DOI: 10.1097/mpa.0000000000002303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
BACKGROUND Pseudoaneurysm usually occurs after vascular injuries or erosions such as in trauma or inflammation like pancreatitis and is associated with high morbidity and mortality. AIM The aim of study is to assess efficacy and safety of EUS-guided thrombin injection in pseudoaneurysm. MATERIALS AND METHODS Prospective data collection was done at SMS Hospital, Jaipur, from January 2015 to March 2023. All patients with pseudoaneurysm were consecutively enrolled. RESULTS Twenty patients (M/F, 18:2) with median age of 41 years (25-58 years), were studied. Underlying etiology of pseudoaneurysm was chronic pancreatitis in 75% of the patients, blunt trauma abdomen in 15% of the patients, recurrent acute pancreatitis in 5%, and idiopathic in 5% of the patients. At the time of admission, mean hemoglobin was 6.7 g/dL (3.4-8.2), with median blood transfusion requirement was 2 units (0-6 units). Hemoglobin values after 4-6 weeks showed a significant improvement ( t = 9.21, P < 0.05).Mean dose of human thrombin required for complete obliteration of pseudoaneurysm was 520 ± 188.6 IU per patient (300-800 IU). Amount of thrombin (IU) dose needed to achieve complete obliteration correlated well significantly with the dimension of pseudoaneurysm, P value less than 0.05 ( R = 0.80). Median follow-up duration in this study was 44 months (3-84 months), which was the longest follow-up period by far. CONCLUSIONS Endoscopic ultrasound-guided thrombin injection in visceral artery pseudoaneurysm is a safe and effective alternative for patients not amenable for digital subtraction angiography-guided angioembolization.
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Affiliation(s)
- Ashok Jhajharia
- From the Department of Gastroenterology, SMS Medical College and Hospital
| | - Shashank Singh
- From the Department of Gastroenterology, SMS Medical College and Hospital
| | - Monika Chaudhary
- Department of Radiology, Santokba Durlabhji Memorial Hospital, Jaipur, India
| | - Mayank Ameta
- From the Department of Gastroenterology, SMS Medical College and Hospital
| | - Prachis Ashdhir
- From the Department of Gastroenterology, SMS Medical College and Hospital
| | - Sandeep Nijhawan
- From the Department of Gastroenterology, SMS Medical College and Hospital
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Liu W, Zhou T, Zhu X, Wu J, Yu J, Zhang Q. A 58-Year-Old Woman with Acute Torsion of the Small Bowel Due to Diffuse Intestinal Lipomatosis. Am J Case Rep 2024; 25:e942527. [PMID: 38519985 DOI: 10.12659/ajcr.942527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
BACKGROUND Diffuse intestinal lipomatosis is a rare condition that infiltrates mature fatty tissue into the intestinal submucosa and subserosa of the small or large intestine and can present with intestinal obstruction or torsion. This report is of the case of a 58-year-old woman who had acute torsion of the small bowel due to diffuse small intestinal lipomatosis. CASE REPORT A 58-year-old woman, who was otherwise in good health, arrived at our Emergency Department experiencing sudden, intense pain in the lower abdomen. She also reported abdominal swelling, feelings of nausea, vomiting, and reduced ability to defecate for at least 2 days. The next morning, contrast-enhanced abdominal computed tomography (CT) scan was performed, showing diffuse thickening of the small intestinal wall with hypodensity, fatty density, lumen narrowing, and wall thinning. The small intestine demonstrated a whirlpool-like distribution in the lower right abdomen and localized thickening of the small intestinal wall, suggesting acute intestinal torsion. An hour later, an emergency operation was performed to remove part of the small intestine. Three days later, pathological results showed a thin intestinal wall, expansion of the mucosal layer and submucosa, and hyperplasia of adipose tissue. CONCLUSIONS This report presents a rare case of torsion and small bowel obstruction caused by diffuse intestinal lipomatosis and focuses on the abdominal enhanced CT scan, which showed diffuse thickening of the small intestine, with multiple areas of fat density and torsion of the small intestine in the right lower abdomen. Histopathology is also presented, with the result showing intestinal lipomatosis.
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Affiliation(s)
- Wenfei Liu
- Department of Imaging, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China (mainland)
| | - Tianyu Zhou
- Department of Imaging, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China (mainland)
| | - Xiaoying Zhu
- Department of Imaging, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China (mainland)
| | - Jianlin Wu
- Department of Imaging, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China (mainland)
| | - Jing Yu
- Affiliated Zhongshan Hospital Of Dalian University, Department of Imaging, Dalian, China (mainland)
| | - Qing Zhang
- Department of Imaging, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China (mainland)
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